In general, manual procedures are a significant source of error in the diagnostic laboratory (eg, manual test procedures, manual pipetting, manually transcribing results, manual calculations, etc.). Also, highly repetitive tasks involved in manual procedures can create stress on laboratory staff. In addition, skill sets and experience vary between workers, often creating uneven levels of quality and productivity. Automation ensures consistency by standardizing processes and eliminating or minimizing variability between laboratory staff members.
Automating the testing process is important, but significant waste is often discovered within the pre- and post-analytical processes. Automation systems, when combined with a laboratory information system (LIS), can support end-to-end processes that record all events from blood collection through reporting of test results. This includes automatic reporting of verified test results (autoverification) as well as sample storage, retrieval, and disposal. Biologic sample collection by the phlebotomy staff and sample handling by central processing staff currently remain the exceptions. "Digitalization of diagnostic laboratories with intelligent software enables better management of testing processes, leading to improved workflow and better clinical outcomes."6 Some examples include:
- Automatic confirmation and transmission of patient results without human intervention (autoverification)
- Real-time, automated consumption tracking, checkout, and ordering of reagents and other consumables (inventory management)
- Laboratory process management, allowing the centralized oversight of the performance of diagnostic systems -- enabling staff to view and control testing, operations, instrument, automation, and information technology across the organization.
The benefits of automating processes in the lab "can be profound".7 Some examples include:
- Decreased Turnaround time
- Freeing the time of the highest-certified staff to review critical samples, conduct research, and perform other high-complexity tasks
- Increased productivity, with fewer and lower-cost staff performing more tests
- Improved quality through reduced manual errors, reduced between-test performer errors, and automated quality control
- Increased flexibility and scalability for future growth
- Reduced biohazard risk through reduced or eliminated sample handling by staff
The downside to extensive automation is affordability. Test volume and cost-benefit ratios are often deciding factors in how much and what kind of automation can be implemented in the laboratory. Fortunately, for smaller diagnostic laboratories, scaled-back less expensive options can be purchased for both testing equipment and data management. However, comparing productivity between the larger lab to the smaller lab will not prove equal. When creating and implementing benchmarks for productivity against other laboratories, it is important to identify other labs with similar missions, test mix, and test volumes.
8. CDC/Gathany. Image #24475. Caption: "This Centers for Disease Control and Prevention (CDC) scientist was operating an instrument that helps prepare samples for nucleic acid amplification testing. This automated machine purifies genetic material, a process that would take much longer if scientists had to perform it manually, in a laboratory. Automation of laboratory procedures greatly improves the speed with which scientists can process tests, and get results to healthcare providers and patients." PHIL public domain. Created 2020. Accessed December 28, 2022.
https://phil.cdc.gov/Details.aspx?pid=244759. CDC/Gathany. Image #24495. Caption: "These Centers for Disease Control and Prevention (CDC) scientists were working together to prepare an automated instrument used for high-throughput testing of SARS-CoV-2 antibodies, using the CDC serologic test. Automation of laboratory processes allows laboratory scientists to reliably process high volumes of biological samples rapidly." PHIL public domain. Created 2020. Accessed December 28, 2022. https://phil.cdc.gov/Details.aspx?pid=24495
